Addressing the opioid epidemic is greater than the sum of its parts

There are a lot of moving pieces when it comes to ending the opioid epidemic, but ultimately they all boil down to one concern--a person who needs help overcoming their dependence on a substance, be that opioids or anything else. 

Wisconsin Department of Health Services (DHS) Secretary-designee Andrea Palm supports a hub-and-spoke model of care that goes beyond treating opioid dependence. Increasing access to treatment for all substance use disorders is vitally important, and she believes any model needs to focus on treating the whole person, and I agree.

Today, we have a better understanding of how trauma can lead to chemical dependency. We know that opioids and substance abuse changes the brain. We get that there are other physical, mental, and emotional issues associated with addiction. You can't treat one without treating all the others. 

It's been said that a journey of  a thousand miles begins with a single step, but for many people, taking that first step means jumping the hurdle that is stigma. The fear of being labeled or judged or abandoned by friends and family is pretty powerful. Ask yourself what your first thought is when you hear that someone, a stranger or someone close to you, has an issue with drugs. Do you judge? Do you feel compassion or disdain? Would you feel the same way if a person you know had diabetes? Opioid addiction is a disease. The sooner we recognize that, the sooner we can get people on the journey toward recovery.

In this issue, we update you on some of the great work that continues to take place at DHS, and beyond, to address Wisconsin's opioid crisis. As always, please don't hesitate to contact me with any questions or comments. Together we can help prevent addiction and dependence and get more people on the journey to recovery so individuals, families, and communities can become whole.

Paul Krupski
Director of Opioid Initiatives
Wisconsin Department of Health Services 

More than 400 people attended our Wisconsin Opioid Crisis: A Trauma-Informed Response training event in Green Bay, April 2-3, 2019. Hosted by our Division of Care and Treatment Services, this conference focused on the intersection of traumatic life experiences and opioid abuse as well as strategies for people responding to Wisconsin’s opioid crisis to be more trauma sensitive in their caregiving to improve outcomes. The entire event was recorded. Watch the sessions.

Representatives of eleven Overdose Fatality Review (OFR) sites, which are supported collaboratively by DHS and the state Department of Justice, gathered last month to share best practices, next steps, lessons learned about identifying gaps in services, and linking people to resources and care. OFRs bring together community partners to investigate overdose deaths and determine what events or circumstances lead to the death. The goal of OFRs is to better understand the context of these deaths and to take immediate action to prevent future deaths. OFRs also:

• identify gaps and barriers in services;
• establish strategies for intervention;
• single out underlying causes of substance use disorders, including mental health issues;
• and determine prevention strategies targeting opioid harm in multiple sectors. 

April's meeting included site specific brainstorming that included identifying positive outcomes of local OFR partnerships and identifying next steps. Presentations were also made on topics including stigma and substance use disorder, data, and recovery programs.   

DHS has partnered with the Wisconsin Association for Perinatal Care to create a Primary Prevention Toolkit. The materials are for patients and providers.  

Are You a Woman of Childbearing Age Taking (or Considering) Opioid Medications? Download a patient education poster that can be placed in a clinical or public health setting frequented by women of reproductive age, who are prescribed opioid medications. 

Patient Information Menu. Get an all-in-one document of patient information that can be printed or sent electronically as a part of patient education materials after a visit. Providers can select the sections relevant to include in discharge instructions. This is also available as a Word document.

Women and Opioids: Education for Providers. Download a provider education two-page handout that can be provided in clinical or other provider educational settings to create awareness and offer key practice recommendations and resources at the point of care. 

Quality Improvement for Primary Prevention of Opioid-Exposed Pregnancies “starter kit” offers ideas to look at clinic-specific data, and/or engage in quality improvement work around primary prevention of opioid-affected pregnancies.  

There's something unique about Wisconsin's newest opioid treatment program. Community Medical Services in West Allis accepts patients 24 hours a day, 7 days per week. The first-of-its-kind clinic in the Midwest is located near the intersection of Highway 100 and National Avenue. It opened April 17.

There are 21 opioid treatment programs in Wisconsin. These programs provide medication-assisted treatment using buprenorphine products, methadone, or naltrexone in conjunction with counseling and other supports. This approach is the most effective way to treat an addiction to opioids.

Most opioid treatment programs open early in the morning and close by early afternoon Monday through Saturday. A 24/7 opioid treatment program allows people to access treatment at any given time when they are ready, not when clinics may be open. Better access and meeting people at the time they need and want support, creates a better opportunity for treatment and recovery. 

A directory of all opioid treatment programs in Wisconsin is available on the DHS website. Information on all opioid treatment services in Wisconsin is available through the Wisconsin Addiction Recovery Helpline. Call 211 or 1-833-944-4673.

Another successful Drug Take-Back Day

The total amount of expired, unneeded, and unused medications collected during Drug Take-Back Day April 27 was 58,408 pounds. Thank you for supporting this event. Wisconsin is among the top states for the amount of medications collected during these events. The next Drug Take-Back Day will be in October. Many drug take-back collections in Wisconsin are open year-round. Use this map to find a location near you.

Expired, unneeded, and unused medications do more than clutter a medicine cabinet; they can be dangerous and lead to accidental poisoning, overdose, and abuse. Thrown in the trash, unused medications can be retrieved and illegally sold. Flushed down the drain, they can contaminate the water supply.

Agencies, businesses, and organizations that serve people who use medications may order up to 100 TakeAway Environmental Return System envelopes from us at no cost. We purchased 10,000 of these envelopes in March. We have distributed more than half of them. Orders will be accepted while supplies last.
Use this online form to place an order.

The TakeAway Environmental Return System is a self-addressed, postage-paid envelope that allows people to mail their unwanted drugs through the U.S. Postal Service to a licensed, secure facility for safe destruction. People fill the nondescript envelope, seal it with the provided tamper-evident seal, and drop it in the mail.

June 4, 2019-Buprenorphine X-Waiver Training, Wauwatosa
June 7, 2019-Meeting of the State Council on Alcohol and Other Drug Abuse, Madison.
June 11-12, 2019-Wisconsin Substance Abuse Prevention Training, Wisconsin Dells.
June 21, 2019-Project ECHO, Online/Statewide
June 28, 2019-Buprenorphine X-Waiver Training, Eau Claire.
July 16-18, 2019-National Alliance for Drug Endangered Children  Conference, La Crosse.
July 16, 2019-Buprenorphine X-Waiver Training, Madison.
July 29, 2019-Buprenorphine X-Waiver Training, Appleton